New fears of an E. coli outbreak forced the CDC to advise all Americans to throw out their romaine lettuce.

The alert comes after a reported 32 people in 11 states became ill from eating contaminated romaine.

As of November 20, 2018, there have been 18 confirmed cases of E. coli illness investigated - three in Ontario and 15 in Quebec - all of whom ranged in age from five to 93. The cases have been reported across 11 different states.

Although no deaths have been reported, six people were hospitalized, the agency said.

Consumers are urged to throw away any and all forms of romaine lettuce in their homes and wash and sanitize any surface where the lettuce was stored. The advice includes all types of romaine lettuce including salad mixes that contain romaine.

Consumers should avoid store-bought romaine, as well as any prepared salads that contain the lettuce.

This investigation is ongoing, and the CDC will provide more information as it becomes available.

The agency said the current outbreak is unrelated to another multi-state rash of E coli infections related to romaine lettuce earlier this year that left five people dead and sickened almost 200.

Despite the current outbreak, neither the Canadian government nor the Food and Drug Administration (FDA) are issuing a formal recall of romaine lettuce.

Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Most E. coli strains are harmless, and some are naturally occurring inside the human digestive system.

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